Adjuncts in hernial repair; a consideration of basic principles.

Abstract

For the surgical repair of certain difficult groin and ventral hernias, many adjuncts have been proposed. At the present time, however, autogenous grafts of fascia lata, whole skin, or dermis, and metallic or synthetic meshes seem to be the most popular. The present report deals with a 10-year experience with hernioplasty. In 108 of 339 patients treated from 1948 to 1958 (Table), adjunctive techniques were consid ered necessary because of marked tissue deficiency, and in many of these cases the problems of local repair were complicated by obesity and other unfavorable constitutional factors. In 20 cases free strips of fascia lata were used, according to the techniques of Gallie. 1 Tantalum mesh was used in 43 cases; whole skin, in 36; cutis grafts, in 6, and nylon mesh, in 3. A significant number of recurrences have been observed in the cases in which adjuncts were used. In general, recurrences have